Healthcare Provider Details

I. General information

NPI: 1295656981
Provider Name (Legal Business Name): RAINBOW HEALTH SERVICES L L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2058 HARFORD RD STE A
BALTIMORE MD
21218-6230
US

IV. Provider business mailing address

2058 HARFORD RD STE A
BALTIMORE MD
21218-6230
US

V. Phone/Fax

Practice location:
  • Phone: 443-462-9379
  • Fax: 410-844-0068
Mailing address:
  • Phone: 443-462-9379
  • Fax: 410-844-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. HASSAN OLASUNKANMI SANUSI
Title or Position: CEO
Credential:
Phone: 443-462-9379